A noninvasive method for measuring portal venous/total hepatic blood flow by hepatosplenic radionuclide angiography.

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Abstract
Radionuclide angiography was used to generate 1st-pass radioactivity vs. time curves for the left heart, right hepatic lobe, right lung, spleen and both kidneys following rapid i.v. injection of 20 mCi of 99mTc-pertechnetate. Seven normal subjects were examined as well as 57 cirrhotic patients, who also underwent angiographic grading of portal venous perfusion. For analysis, 2 time points were identified: to, when 99mTc 1st entered the liver (the initial rise of either curve); and tc, when 99mTc was maximal in abdominal organs (the renal peak). Analysis was based on the slopes of the 2 phases of the hepatic curves to + 7 s and tc + 7 s; this time selection permitted analysis of all curves. The hepatic perfusion index (HPI) = slope (T c + 7 s) + slope (Tc + 7 s). The mean HPI for the normal subjects was 66% .+-. 7; for the cirrhotic patients with angiographic Grades I, II, III and IV, the HPI was 52% .+-. 9, 37% .+-. 6, 15.degree. .+-. 7, and 3% .+-. 4, respectively. Correlation between HPI and angiography was significant (P < 0.001). This method offers a readily available, rapid, relatively inexpensive and quantitative method of grading the ratio of portal venous to total hepatic blood flow.